Department of Planning, Transport and Infrastructure

APPLICATION TO: Professional and

Technical Services (Pre-qualification No. 17C811)

CONTACT FOR FURTHER INFORMATION

E-mail: DPTI.Prequal@sa.gov.au

APPLICATIONS MAY BE EITHER:

Be complied on a USB memory device or CD and either:

posted to GPO Box 1533, ADELAIDE SA 5001; or

delivered to 77 Grenfell Street, ADELAIDE SA 5000; or

Emailed to DPTI.Prequal@sa.gov.auNote: If submitting via email, please phone (08) 8343 2029 to confirm receipt. Also, it may be necessary to split the application into several emails to keep it to an acceptable size.

17C811 Professional and Technical Services Pre-qualification 1

Services Covered by 17C811 Professional and Technical Services

Category ServicesAsbestos Management

- AR1: Asbestos Removal Simple - AR2: Asbestos Removal Complex- AR3: Asbestos Survey’s, Site monitoring- AR4: Air Monitoring

Contamination - Contamination Services

Environmental - Environmental Planning & Impact Assessment- Environmental Auditing- Environmental Training- Noise /Vibration- Air Quality- Dilapidation

Landscaping & Arboriculture

- General Landscape Construction- Revegetation- Irrigation- Herbaceous Weed Control- Woody Weed Control- Bushcare- Landscape Maintenance- Arboriculture

Landscape and Urban Design

- Landscape Design- Urban Design- Irrigation Design

Heritage - Indigenous Heritage- Non-Indigenous Built Heritage

Pavement Engineering

- Pavement Design- Traffic Load Distribution- Traffic Counts/Counting- Geotechnical Testing- Consultant Design/Advice including Proof Engineering &

Verification- Traffic Management- Performance Testing – Resilient Modulus, Deflectograph, Skid

ResistanceRail Professional and Technical

- Alignment & Track Infrastructure - Signalling & Communication- Electrification- Stations- Depots & Stabling Yards- Crossings- Light & Heavy Passenger Rail

Geospatial Surveying

- Cadastral Survey- Engineering Survey- Construction Survey- GIS Services- Aerial Imagery & Remote Data Capture

Structural Engineering

- Structural Design- Structural Drafting- Bridge Inspections/ Safety Audits

Geotechnical Services

- Geotechnical Sampling- Foundation design

17C811 Professional and Technical Services Pre-qualification 2

Category ServicesTransport Planning & Highway Design

- RD1 – Road Design- RD2 – Lighting Design - RD3 – Traffic Signal Design- RD4 - Traffic Modelling - RD5 – Concept Planning- RD6 – ITS (Intelligent Transport System Design)

Stormwater - Stormwater Design and Modelling

Vegetation Services

- Ecological Survey / Assessment (Flora & Fauna)- Tree Assessments

Disability Discrimination Act 1992 (DDA) Compliance

- Transport DDA Compliance- Premises DDA Compliance

17C811 Professional and Technical Services Pre-qualification 3

INSTRUCTIONS

GeneralCompanies (Applicants) wishing to apply for prequalification for Professional and Technical Services with the Department of Planning, Transport and Infrastructure (DPTI) must contact DPTI to determine which disciplines have the capacity for more suppliers before completing an application.

Companies must then fill out this Application Form and attach the information requested.

Complete the Application Form and save as a .docx or .pdf file (without these instructions).

save the attachments as .pdf files. Where the files are small, they should be combined so that an absolute maximum of 10 files in total are submitted. Strictly follow the numbering system in this form when preparing the attachments.

Submitting the Application Applications must:

a) include all documentation outlined in this Application Form, together with any other supporting technical or financial information;

b) include file names which clearly indicate the applicable section numbers of this application that are addressed in the file; and

c) be submitted to DPTI.Prequal@sa.gov.au with the following subject line:

NEW APPLICATION – 17C811 PROFESSIONAL AND TECHNICAL SERVICES

Do not submit a hard copy.

Enquiries may be directed to DPTI.Prequal@sa.gov.au or phone (08) 8343 2029.

Publication of DetailsOnce prequalified, the contact details provided in this Application Form will be published on the following internet site: http://www.dpti.sa.gov.au/documents/contractsandtenders/prequalification.

It is the Applicant’s responsibility to ensure that the contact details provided are up to date.

Contractors must be registered on the SA Tenders and Contract internet site (https://www.tenders.sa.gov.au ) to receive invitations to tender.

1.1

17C811 Professional and Technical Services Pre-qualification 4

1. APPLICATION FORM

Supplier Information

Trading Name <insert name>

Registered Name <insert name>

ACN <insert number>

ABN <insert number>

Address of registered office <insert address>

Place of business in South Australia (if relevant)

<insert address>

Type of entity (e.g. company, trust, partnership, sole trader, other)

<insert entity>

Key Personnel (e.g. directors, chief executive officer, principal of business etc)

<insert names and positions>

Telephone <insert phone number>

Website <insert URL>

Contact Details

Contact Person <insert name>

Position <insert position>

Address <insert address>

Postal address <insert address, if different to the above>

E-mail <insert email address>

Telephone <insert phone number>

Conflict Of Interest

You must provide details of any actual or perceived interests, relationships or clients which may cause a conflict of interest or potential conflict of interest, and actions to prevent or manage the conflicts of interest.

<Supplier Name> 5 Application Response

Financial Viability

You are required to demonstrate that You have the financial viability to deliver the Government Agency’s Requirement. The following questions apply to Your business, its parent or any associated entities or any director(s), including any consortium members and partners where relevant.

If the answer to any of the following questions is ‘yes’, provide an explanation.

Are there any significant events, matters or circumstances which have arisen within the past 12 months that could significantly affect Your operations? Have there been any:

bankruptcy and/or de-registration actions; or insolvency proceedings (including voluntary administration, application to

wind up, or other like action), either actual or threatened, against You in the past three years? If so, what (if any) remedial action has been taken?

Yes/No

Are You currently in default of any agreement, contract, order or award that would or would be likely to adversely affect Your financial capacity to deliver the Government Agency’s Requirement? Are there any other factors which could adversely impact on Your financial ability to successfully perform the obligations in this Application?

Yes/No

Risk Management

Provide details of the risk management strategies and practices that You would implement in the delivery of the Government Agency’s Requirement.

Provide details of Your Workplace Health and Safety record over the previous three years. This should include the number of accidents, number of lost time accidents, etc.

<Supplier Name> 6 Application Response

Value for Money

What is Your strategy and methodology to ensure that value for money is achieved and delivered?

Insurances

Provide details of each insurance policy relevant to the Government Agency’s Requirement.

Public Liability Insurance

Certificate of Currency of Public Liability Insurance attached to this response document

Yes/No

Value of Insurance

Validity of Insurance

Professional Indemnity Insurance

Certificate of Currency of Professional Indemnity Insurance attached to this response document

Yes/No

Value of Insurance

Validity of Insurance

Prequalification Discipline(s) Being Applied For

Please specify sub-categories where appropriate.

<Supplier Name> 7 Application Response

Compliance

Terms and Conditions

Does your offer comply with the proposed Terms and Conditions outlined in Attachment 1.

Yes/No

Specifications

Does your offer comply with the relevant specifications outlined in the Prequalification Guidelines? Please attach any relevant documentation.

Yes/No

Panel Special Conditions

The following special conditions will apply to all suppliers appointed to the Professional and Technical Services pre qualification:

1. Any supplier will be removed, if the supplier:a. Does not respond to a request for quote for one year having been offered at least

three opportunities to tender, or b. Three consecutive non-conformances or three non-conformances within one

calendar year, or c. Fails to demonstrate their ability to meet the minimum assessment requirements

for their appointed service categories due to staff changes. Suppliers are required to notify DPTI of any staff changes.

2. Suppliers demonstrating poor performance may also be reduced to low value/ low risk engagements of <$33 000 incl GST subject to the following methodologya. Three suggested improvements within one calendar year, orb. Two consecutive non-conformances or, two non-conformances within one calendar

year

Do You accept the Special Conditions of the pre qualification?

Yes/No

FOR OFFICE USE ONLY

................Application(s) opened on ............./............/2018

By: .................................................................... ...........................................................(Signature of Authorised Officer) (Printed Name of Authorised Officer)

And: .................................................................... ...........................................................(Signature of Authorised Officer) (Printed Name of Authorised Officer)

<Supplier Name> 8 Application Response

2. Requirements and TEMPLATES

Organisational StructureProvide details of Your organisational structure and the business units relevant to the delivery of the Government Agency’s Requirement (including any necessary diagrams).

Management SystemsProvide details of Your Management Systems covering quality and document control processes, non-conformance management, staff training and development, organisational development, safety systems and Safe Work Method Statements (SWMS).

<Supplier Name> 9 Application Response

Work historyWork History shall include a minimum of 3, and a maximum of 5 relevant project examples completed within the past 2 years per nominated service category. Include evidence, project value, details and referees.

Nominated Service Category: <insert nominated service category as per Column B>

Capability Statement of Your company for this Service Category: <insert capability statement for the nominated service category in no more than 150 words as per Column B>

Project Example 1:Project Title: <insert project title and name of client organisation>

Project Details: <insert project details including scope of work, deliverables, indicate if the project was delivered on time and within budget>

<limit details to no more than 150 words>

Project Value <insert project value>

Project Referees <insert title, name, address, e-mail and telephone number of contact person at client organisation>

Project Example 2:

Project Title: <insert project title and name of client organisation>

Project Details: <insert project details including scope of work, deliverables, indicate if the project was delivered on time and within budget>

<limit details to no more than 150 words>

Project Value <insert project value>

Project Referees <insert title, name, address, e-mail and telephone number of contact person at client organisation>

10

<insert additional table/s for additional Work History>

11

Qualifications and Experience of key staffDetail the experience and expertise of each key staff member and their role per nominated service category:

Nominated Service Category: <insert nominated service category as per Column B>

Name <insert name>

Qualifications <insert qualifications>

Skills <insert skills>

Relevant Experience <insert relevant experience>

Availability for duration of contract <insert availability>

Location <insert location of resource>

Role in delivery of Government Agency’s Requirement

<insert role>

Name <insert name>

Qualifications <insert qualifications>

Skills <insert skills>

Relevant Experience <insert relevant experience>

Availability for duration of contract <insert availability>

Role in delivery of Government Agency’s Requirement

<insert role>

12

<insert additional table/s for additional Key Staff>

13

Rates Cards*Please endeavour to match your staff to the roles outlined below. Only include a rate card to the relevant services in your response document.**Rates shall be inclusive of GST

Hourly Rate ($)Services Position/Role Supplier Comment 0– 3 months 3 – 6 months 6+ months

Asbestos Management Project ManagerSenior Asbestos RemovalistAsbestos RemovalistClearance Inspection (per day)Air Monitoring (per day)Extra Monitor (per day)

Contamination PrincipalContamination AuditorProject ManagerSenior ScientistScientist

Environmental Services - Environmental Planning & Impact Assessment

PrincipalProject ManagerSenior ScientistScientistPlanner

Environmental Services - Environmental Auditing /Environmental Training / Noise & Vibration / Air Quality

PrincipalEnvironmental AuditorProject ManagerSenior EngineerSenior Scientist

14

Hourly Rate ($)Services Position/Role Supplier Comment 0– 3 months 3 – 6 months 6+ months

EngineerScientist

Landscaping & Arboriculture

Project ManagerSenior SpecialistSpecialistTechnical Assistant

Landscape and Urban Design

PrincipalSenior ArchitectArchitectDesignerDrafterTechnician

Heritage Principal ArchitectPrincipal EngineerSenior ArchitectArchitectGraduate ArchitectAdministration OfficerSenior ArchaeologistArchaeologistCivil/Structural EngineerCoatings and Corrosion EngineerConservatorCost Manager

15

Hourly Rate ($)Services Position/Role Supplier Comment 0– 3 months 3 – 6 months 6+ months

HistorianMaterials ScientistTechnical OfficerScaffold Engineer

Pavement Engineering PrincipalProject ManagerSenior EngineerEngineerSenior DesignerDesignerTechnical Officer

Rail Professional and Technical Services

PrincipalProject ManagerSenior Engineer (Electrical)Senior Engineer (Civil)Engineer (Electrical)Engineer (Civil)Senior DesignerDesignerTechnical Officer

Geospatial Surveying - Cadastral / Engineering / Construction Survey

Project ManagerField SurveyorSurvey AssistantDrafter

16

Hourly Rate ($)Services Position/Role Supplier Comment 0– 3 months 3 – 6 months 6+ months

Cadastral SearcherAdministration OfficerSpecialist Equipment (per day)

Geospatial Surveying - GIS Services

Project ManagerSenior GIS AnalystGIS AnalystAdministration OfficerSpecialist Equipment (per day)Senior GIS Analyst

Geospatial Surveying - Aerial Imagery & Remote Data Capture

Project ManagerSenior ConsultantConsultantAdministration OfficerSpecialist Equipment (per day)

Structural Engineering PrincipalProject ManagerSenior EngineerEngineerSenior DesignerDesignerTechnical Officer

Geotechnical PrincipalProject ManagerSenior Engineer

17

Hourly Rate ($)Services Position/Role Supplier Comment 0– 3 months 3 – 6 months 6+ months

Senior ScientistEngineerField SupervisorField ScientistTechnical Reviewer

Transport Planning & Highway Design - Road / Lighting / Traffic Signal Design / Traffic Modelling

PrincipalProject ManagerElectrical EngineerCivil EngineerSenior DesignerDesignerDrafterTechnical ReviewerSenior ModellerModeller

Transport Planning & Highway Design - Concept Planning

Project ManagerSenior PlannerPlannerGIS AnalystEconomist

Stormwater Design & Modelling

PrincipalProject ManagerSenior HydrologistHydrologist

18

Hourly Rate ($)Services Position/Role Supplier Comment 0– 3 months 3 – 6 months 6+ months

Senior Stormwater EngineerStormwater EngineerGIS AnalystGraduateDrafterOther

Vegetation PrincipalProject ManagerSenior Consultant/EcologistConsultant/EcologistField OfficerField AssistantOther

DDA Compliance PrincipalProject ManagerSenior SpecialistSpecialistOther

19

3. SCHEDULE CHECKLIST FOR APPLICATION

For each item please tick the box to indicate that the Schedule has been completed and included with your Application.

0 Contact DPTI before completing an Application

1 Schedule of Rates. □2 Certificate of Currency of Public Liability Insurance. □3 Certificate of Currency of Professional Indemnity. □4 Organisational Structure. □5 Work History. □6 Management Systems. □7 Qualifications and Experience. □8 Application Form. □

20

ATTACHMENT 1

The terms and conditions for contract are the State Procurement Board Goods and Services Agreement and/or Australian Standard 4122-2010 General Conditions of Contract and Special Conditions for Professional Consulting Services.

For a quick link to DPTI General Conditions of Contract, please follow the following link:

https://www.dpti.sa.gov.au/contractor_documents/dpti_general_conditions_of_contract

Terms and Conditions and Insurance Requirements

Category Services Terms and Conditions

Insurance

Asbestos Management

- AR1: Asbestos Removal Simple

- AR2: Asbestos Removal Complex

- AR3: Asbestos Survey’s, Site monitoring

- AR4: Air Monitoring

SPB G&S Public Liability $10mSpecialised Asbestos Removal Insurance

Contamination - Contamination Services SPB G&S Public Liability $10mProfessional Indemnity $5m

Environmental - Environmental Planning & Impact Assessment

- Environmental Auditing- Environmental Training- Noise /Vibration- Air Quality- Dilapidation

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Landscaping & Arboriculture

- General Landscape Construction

- Revegetation- Irrigation- Herbaceous Weed Control- Woody Weed Control- Bushcare- Landscape Maintenance- Arboriculture

SPB G&S Public Liability $10mProducts Liability $10m

Landscape and Urban Design

- Landscape Design- Urban Design- Irrigation design

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Heritage - Indigenous Heritage- Non-Indigenous Built Heritage

SPB G&S Public Liability $10mProfessional Indemnity $5m

Pavement Engineering

- Pavement Design - Traffic Load Distribution   - Traffic Counts/Counting   - Geotechnical Testing        - Consultant Design/Advice

including Proof Engineering & Verification           

- Traffic Management         - Performance Testing –

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

21

Category Services Terms and Conditions

Insurance

Resilient Modulus, Deflectograph, Skid Resistance

Rail Professional and Technical

- Alignment & Track Infrastructure

- Signalling & Communication- Electrification- Stations- Depots & Stabling Yards- Crossings- Light & Heavy Passenger Rail

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Geospatial Surveying

- Cadastral Survey- Engineering Survey- Construction Survey- GIS Services- Aerial Imagery & Remote Data

Capture

SPB G&S Public Liability $10mProfessional Indemnity $5m

Structural Engineering

- Structural Design- Structural Drafting- Bridge Inspections/ Safety

Audits

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Geotechnical - Geotechnical Sampling- Foundation design

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Transport Planning & Highway Design

- RD1 – Road Design- RD2 – Lighting Design - RD3 – Traffic Signal Design- RD4 - Traffic Modelling - RD5 – Concept Planning- RD6 – ITS

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Stormwater - Stormwater Design and Modelling

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

Vegetation - Ecological Survey / Assessment (Flora & Fauna)

- Tree Assessments

SPB G&S Public Liability $10mProfessional Indemnity $5m

DDA Compliance

- Transport DDA Compliance- Premises DDA Compliance

AS4122-2010

Public Liability $10mProfessional Indemnity $5m

22